A Shorter Course Antibiotic Treatment Effective in Treating Pediatric Community-Acquired Pneumonia

The researchers conducted a randomized clinical trial to compare whether a shorter course of treatment vs a longer course of treatment is the suitable option for pediatric patients with nonsevere CAP.

For their study, the researchers used various data sources including MEDLINE and the Cochrane Library.  Data were extracted using random-effects models, which were analyzed from April 15, 2022, to May 15, 2022. Their main outcome was treatment failure, which they defined as the persistence of pneumonia or any general signs of CAP after treatment was completed.

In total, the researchers analyzed nine clinical trials that included 11,143 participants, with most of the participants aged 2 months to 5 years old. In eight studies, treatment failure was reported for 10,662 patients. Treatment failure occurred in 12.8% of participants undergoing a shorter course of antibiotics. In comparison, 12.6% of participants experienced treatment failure with a longer course of antibiotics.

The results indicated that a shorter 3-day course of oral antibiotics is not worse than a longer 5-day course of treatment with respect to treatment failure for pediatric patients with nonsevere CAP. Additionally, a 5-day course of antibiotics was noninferior to a 10-day course of treatment for nonsevere CAP.

The authors noted some important limitations to their study. First, although they studied multiple infection types, the authors noted the possibility that the ideal duration for different infection types may vary. Additionally, the definitions for “pneumonia” and “treatment failure” varied across studies investigated by the authors, which may have led to heterogeneity in their results. Finally, the authors did not analyze long-term outcomes due to lack of data.

Still, the researchers noted that a shorter course of antibiotic treatment was associated with fewer reports of gastroenteritis and lower caregiver absenteeism.

“Clinicians should consider prescribing a shorter course of antibiotics for the management of pediatric nonsevere CAP,” the researchers concluded.

—Jessica Ganga

Reference:

Li Q, Zhou Q, Florez ID, et al. Short-course vs long-course antibiotic therapy for children with nonsevere community-acquired pneumonia. JAMA Pediatr. 2022;176(12):1199-1207. doi:10.1001/jamapediatrics.2022.4123